The audiologist noted that the bone conduction thresholds in the right ear were reported as heard, not felt.

NU-6 ½ lists

MCL = 105 dB HL Right, 65 dB HL Left

• The audiogram shows what type of loss?
• At what frequencies are the right ear bone-conduction thresholds significantly worse than those for the left ear? Is the decreased bone conduction scores for the right ear (compared to the left ear) consistent with the preliminary diagnosis of otosclerosis or not? (Compare the finding to the classic “Carhart’s notch.”
• The left ear shows some bone-air gaps.  That would mean that hearing via the inner ear is worse than the hearing when sound goes through the middle ear and then to the inner ear.  How can that happen?
• Did the air-conduction thresholds shift significantly when contralateral masking was applied?
• What is the minimum interaural attenuation value for insert earphones? What is the difference between the right ear unmasked threshold at 1000 Hz and the left ear air conduction threshold?  Why didn’t the unmasked right air threshold come in at a lower intensity?
• What are the three frequency pure-tone averages for each ear? How do they compare to the spondee thresholds?
• What is “MCL” and how did that influence the choice of word recognition test level?
• How many decibels sensation level are the right and left ear word recognition testing levels?
• Do you think that choice of level influenced the score for the left ear?  Is the left ear score “abnormally low” (see case 5 audiometrics for reference).